Ultraschall in Der Medizin最新文献

{"title":"Significance of high-resolution ultrasound imaging and elastography as early predictors of diabetic peripheral neuropathy.","authors":"Ahmed Elshimy, Ghada Elshimy, Ahmed Mohamed Abouelhoda, Ahmed Abdellatif Awad, Omar Farouk","doi":"10.1055/a-2589-8675","DOIUrl":"https://doi.org/10.1055/a-2589-8675","url":null,"abstract":"<p><p>To evaluate the significance of high-resolution ultrasound (HRUS) and shear wave elastography (SWE) in the diagnosis of diabetic peripheral neuropathy (DPN) to clarify their possible roles as early predictors of the occurrence of this important complication.The study included 90 patients with diabetes mellitus with different clinical stages of DPN as well as 30 healthy controls. A full history, clinical examination, and assessment of both the Toronto Clinical Neuropathy Score (TCNS) and HbA_1c were performed, followed by real-time HRUS and SWE examinations of their right and left tibial and median nerves to assess their cross-sectional area (CSA) and nerve stiffness, respectively.The CSA and stiffness of tibial and median nerves were significantly increased in patients with diabetes compared to controls, with higher values associated with the severity of their DPN. Both parameters were correlated with each other and with the duration of the disease, TCNS, and HbA_1c. The CSA cut-off value of both tibial and median nerves to detect DPN in patients was 13.5 mm², meanwhile, the SWE cut-off values were 68.5 and 61.5 KPa, respectively. SWE showed a higher AUC than CSA for the prediction of DPN.Measurement of the CSA and stiffness of the peripheral nerves could be a reliable tool for early detection of DPN. Therefore, we recommend adding these noninvasive diagnostic parameters as complementary diagnostic tools to the routine follow-up schedule of diabetic complications, especially in long-standing cases.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Value of cerebroplacental ratio in predicting adverse perinatal outcome in uncomplicated twin pregnancies: a retrospective study.","authors":"Gabriel Eisenkolb, Chiara Lecce, Nina Draeger, Anne Karge, Silvia M Lobmaier, Kathrin Abel, Eva Ostermayer, Bettina Kuschel, Javier U Ortiz, Oliver Graupner","doi":"10.1055/a-2566-8912","DOIUrl":"https://doi.org/10.1055/a-2566-8912","url":null,"abstract":"<p><p>To evaluate the performance of the cerebroplacental ratio (CPR) in predicting operative delivery for intrapartum fetal compromise (OD for IFC) and adverse perinatal outcomes in uncomplicated twin pregnancies with attempted vaginal delivery.This was a retrospective cohort study of 72 twin pregnancies in a single tertiary referral center between January 2018 and August 2024. All MCDA and DCDA twin pregnancies with an attempted vaginal delivery after 34+0 weeks were screened for eligibility and those without further risk factors were included in the study. Outcome parameters were OD for IFC and a composite of adverse perinatal outcomes (CAPO) including OD for IFC, 5-minute Apgar score <7, umbilical artery pH <7.10, or admission to the neonatal intensive care unit (NICU). The predictive performance of CPR was evaluated using ROC analyses and multivariable logistic regression.16 MCDA and 56 DCDA pregnancies met the inclusion criteria. CAPO of at least one of the twins occurred in 27 (37.5%) of the cases. ROC analyses showed that low CPR MoM of neither the presenting twin nor the second twin predicted CAPO. Similarly, the prediction of the need for OD for IFC of twin 2 was not possible using low CPR MoM as the predicting variable. However, logistic regression analyses showed that nulliparity and twin-to-twin delivery time interval were independently associated with CAPO.Low CPR MoM was not predictive for CAPO or OD for IFC in uncomplicated twin pregnancies after 34 weeks of gestation. However, nulliparity and twin-to-twin delivery time interval were independently associated with CAPO.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expert learning in musculoskeletal ultrasound - an international observational study.","authors":"Stine Maya Dreier Carstensen, Lawrence Grierson, Lars Konge, Søren Andreas Just, Mogens Pfeiffer-Jensen, Mikkel Ostergaard, Ingrid Möller, Maribel Miguel, Luis Coronel, David Bong, Lene Terslev","doi":"10.1055/a-2532-6860","DOIUrl":"https://doi.org/10.1055/a-2532-6860","url":null,"abstract":"<p><p>To examine the effect of discovery learning on musculoskeletal ultrasound (MSUS) performance and to explore how expert learners engage in a collaborative learning environment.Experts in MSUS participated in a discovery learning session where they were divided into groups. Each participant had one attempt to solve the same MSUS case and could seek assistance from other group members or learning resources. The video-recorded sessions were analyzed using both quantitative and qualitative methods. Performance was assessed using the validated Objective Structured Assessment of Ultrasound Skills (OSAUS) tool (1-5 points per item), and an outcome score was calculated based on the number of correct MSUS images (0-4). Participants' comfort and perception of discovery learning were evaluated using a 5-point Likert scale questionnaire.28 MSUS experts from 13 different countries completed the study. The mean OSAUS score (standard deviation) was 3.96 (0.5), and the mean outcome score was 1.89 (0.9). Using Pearson's correlation coefficient, we found a significant correlation between the OSAUS score and the outcome score (0.72, p < .001). The qualitative analysis revealed that the experts used actions associated with adaptive expertise and that social hierarchy persisted in the collaborative learning environment. Finally, we found high comfort with and acceptance of the discovery learning approach.Discovery learning may be an effective teaching strategy for future advanced MSUS courses, including international Teach-the-Teachers courses. Since social hierarchy was present, a facilitator is necessary during collaborative training.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of real-time ultrasound guidance on ventricular catheter placement in cerebrospinal fluid shunts - a single-center study.","authors":"Sevgi Sarikaya-Seiwert, Arndt-Hendrik Schievelkamp, Mark Born, Christian Wispel, Hannes Haberl, Ehab Shabo","doi":"10.1055/a-2352-9404","DOIUrl":"10.1055/a-2352-9404","url":null,"abstract":"<p><p>Misplacement of ventricular catheters during shunt surgery occurs in 40% of cases using a freehand technique and therefore represents a risk for early shunt failure. The goal of this retrospective, single-center study is to analyze the impact of real-time ultrasound guidance on ventricular catheter positioning and early outcome of shunt survival.We analyzed the charts and images of all patients who underwent shunt surgery from 09/2017 to 12/2022 and compared the position of the ventricular catheter using the freehand technique and real-time ultrasound guidance. Central catheter position was graded as grade I (optimal), II (contact with ventricle structures or contralateral), and III (misplacement).A ventricular catheter was placed in 244 patients using real-time US guidance and in 506 patients using a freehand technique. The mean age (53.4 and 53.6 years, respectively) and the preoperative frontal occipital horn ratio (FOHR; 0.47 versus 0.44) were almost equal in both groups. In the study group, grade I catheter position was achieved in 64% of cases, grade II in 34%, and grade III in 2%. The control group showed grade I position in 45%, grade II in 32%, and grade III in 23% of cases (p<0.05). An early central catheter failure rate was the highest in grade III (40.5%) compared to 4% in grade I.Our data demonstrate that real-time US guidance leads to a significant improvement in ventricular catheter placement. Consequently, early shunt revisions decrease significantly. Further prospective, randomized, and controlled studies comparing the standard method to real-time ultrasound catheter placement are required.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":"170-176"},"PeriodicalIF":3.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Firsttrimester Diagnosis and Therapy @ 11-13+6 Weeks of Gestation - Part 2.","authors":"Constantin von Kaisenberg, Peter Kozlowski, Karl-Oliver Kagan, Markus Hoopmann, Kai-Sven Heling, Rabih Chaoui, Philipp Klaritsch, Barbara Pertl, Tilo Burkhardt, Sevgi Tercanli, Jochen Frenzel, Christine Mundlos","doi":"10.1055/a-2280-4887","DOIUrl":"10.1055/a-2280-4887","url":null,"abstract":"<p><p>This extensive AWMF 085-002 S2e-guideline \"First Trimester Diagnosis and Therapy @ 11-13⁺⁶ Weeks of Gestation\" has systematically analyzed high-quality studies and publications and the existing evidence (evidence tables) and produced recommendations (level of recommendation, level of evidence, strength of consensus).This guideline deals with the following topics in the context of the 11-13⁺⁶ weeks scan: the legal basis, screening for anatomical malformations, screening for chromosomal defects, quality assessment and audit, screening for preeclampsia and FGR, screening for preterm birth, screening for abnormally invasive placenta (AIP) and placenta accreta spectrum (PAS), screening for velamentous cord insertion and vasa praevia, screening for diabetes mellitus and LGA.Screening for complications of pregnancy can best be carried out @ 11-13⁺⁶ weeks of gestation. The issues of how to identify malformations, chromosomal abnormalities and certain disorders of placentation (high blood pressure and proteinuria, intrauterine growth retardation) have been solved. The problem of how to identify placenta percreta and vasa previa has been partially solved. What is still unsolved is how to identify disorders of glucose metabolism and preterm birth.In the first trimester, solutions to some of these problems are available: parents can be given extensive counselling and the risk that a pregnancy complication will manifest at a later stage can be delayed and reduced. This means that screening is critically important as it helps in decision-making about the best way to manage pregnancy complications (prevention and intervals between follow-up examinations).If no treatment is available and if a termination of pregnancy is considered, the intervention can be carried out with far lower complications compared to the second trimester of pregnancy. In most cases, further examinations are not required and the parents can be reassured. A repeat examination at around week 20 of gestation to complete the screening for malformations is recommended. NOTE: The guideline will be published simultaneously in the official journals of both professional societies (i.e. Ultraschall in der Medizin/European Journal of Ultrasound for the DEGUM and Geburtshilfe und Frauenheilkunde for the DGGG).</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":"145-161"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-guided breast-conserving surgery compared to conventional breast-conserving surgery.","authors":"Bettina Boeer, Jennifer Obermoser, Mario Marx, Birgitt Schönfisch, Marcel Grube, Carmen Röhm, Gisela Helms, Regina Fugunt, Andreas D Hartkopf, Sara Y Brucker, Markus Hahn","doi":"10.1055/a-2290-1543","DOIUrl":"10.1055/a-2290-1543","url":null,"abstract":"<p><p>The goal of breast-conserving surgery is to achieve negative tumor margins, since insufficient marginal distance is associated with more local and distant recurrences. This study investigates whether IOUS (intraoperative ultrasound) can reduce the re-resection rate compared to standard breast surgery, regardless of tumor biology and focality.The present study is a monocentric, prospective, randomized, and non-blinded parallel group study conducted between 7/2015 and 2/2018. Patients with sonographically visible breast cancer were randomized into two study arms: 1) breast-conserving surgery with IOUS; 2) conventional arm.364 patients were included in the study and underwent surgery. Tumor biology, size, and focality were equally distributed in both groups (p = 0.497). The study arms did not differ significantly in the proportion of preoperative wire markings (p= 0.084), specimen weight (p = 0.225), surgery duration (p = 0.849), and the proportion of shavings taken intraoperatively (p = 0.903). Positive margins were present in 16.6% of the cases in the IOUS arm and in 20.8% in the conventional arm (p = 0.347). Re-operation was necessary after intraoperative shavings in 14.4% of cases in the US arm and in 21.3% in the conventional arm (p = 0.100).Although the present study showed a clear difference in the rate of positive tumor margins with IOUS compared to conventional breast surgery without IOUS, this was not statistically significant in contrast to the current literature. This could be due to the high expertise of the breast surgeons, the precise wire marking, or the fact that the IOUS technique was not standardized.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":"162-169"},"PeriodicalIF":3.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-guided neuromodulation with pulsed RFA - a treatment option for chronic neuroma pain?","authors":"Elisabeth Skalla-Oberherber, Hannes Gruber","doi":"10.1055/a-2520-5634","DOIUrl":"https://doi.org/10.1055/a-2520-5634","url":null,"abstract":"","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":"46 2","pages":"116-119"},"PeriodicalIF":3.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral persistent sciatic arteries with right sciatic artery aneurysm thrombosis and distal embolization: A case report.","authors":"Yanzhou Liu, Wensheng Yue, Duo Huang","doi":"10.1055/a-2444-2843","DOIUrl":"10.1055/a-2444-2843","url":null,"abstract":"","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":"196-198"},"PeriodicalIF":3.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transabdominal ultrasound for the diagnostic workup of parenchymal pancreatic diseases.","authors":"Robert Henker, Valentin Blank, Thomas Karlas","doi":"10.1055/a-2336-1700","DOIUrl":"10.1055/a-2336-1700","url":null,"abstract":"<p><p>This continuing medical education article highlights the central role of transcutaneous sonography in diagnosing parenchymal pancreatic diseases. It emphasizes the importance of in-depth knowledge of sonographic imaging of organ anatomy and a structured examination methodology, particularly for identifying acute and chronic pancreatitis and related complications. The article provides detailed guidance for optimized examination techniques and equipment settings, even under challenging conditions, and discusses the application of ultrasound in various scenarios of pancreatic diseases. Moreover, the relevance of advanced sonographic techniques such as high-frequency sonography, elastography, and contrast-enhanced sonography is illuminated in the context of expanded diagnostic workup.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":"124-144"},"PeriodicalIF":3.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic and safety value of ultrasound-guided transthoracic core needle biopsy for mediastinal masses: a single-center experience.","authors":"Paolo Poisa, Paolo Malerba, Anna Orsini, Linda Sabbadini, Maria Grazia De Tavonatti, Stefania Cecchinel, Paola Orizio, Stefano Caletti, Erkin Saeed Saifi, Matteo Nardin, Giovanni Pelizzari","doi":"10.1055/a-2511-5757","DOIUrl":"10.1055/a-2511-5757","url":null,"abstract":"<p><p>US-guided (Ultrasound-guided) percutaneous transthoracic core needle biopsy (CNB) is a favorable method for establishing the correct diagnosis of mediastinal masses. However, studies in this area are scant and often include small samples, thus making it difficult to provide robust evidence regarding the safety and efficacy of this procedure. Thus, we aimed to report on the 20 years of experience at our center with regard to US-guided CNB.We included all consecutive patients referred to our center to undergo US-guided percutaneous transthoracic CNB for a mediastinal mass between 1999 and 2022. Descriptive statistics were used to display data. A multivariate logistic regression analysis was used to inquire about predictors of diagnostic sampling.The final cohort included 140 patients with a median age of 37 years. In 20.7% of the cases, the mediastinal mass was an incidental finding. The parasternal approach was used most often. US-guided CNB was diagnostic in 84.3% of the patients and most of the diagnoses included hematological neoplasms. The reasons for non-diagnostic sampling included firm lesion consistency, low quantity of samples, and lesion necrosis. The parasternal approach resulted in an independent predictor of diagnostic sampling (AOR 4.16, 95% CI 1.14-15.23, p=0.031), while a bulky feature revealed only a trend for diagnostic sampling. One non-severe adverse event occurred, with spontaneous resolution.US-guided percutaneous transthoracic CNB is an effective and safe procedure that allows the diagnosis of mediastinal masses. The identification of patients that could benefit from this technique should be the next step in researching this topic.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":"186-193"},"PeriodicalIF":3.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}